Journal of affective disorders最新文献

This study investigated trends in psychological distress and mental health service use in Japan before and after the COVID-19 pandemic using nationally representative data from the Comprehensive Survey of Living Conditions (2013-2022). Psychological distress was assessed using the Japanese version of the Kessler 6 Scale, with scores of 5-12 indicating moderate distress and scores of ≥13 indicating high distress. Mental health service use was defined as regular visits to hospitals or clinics for depression or other psychological disorders. Analysis of data from 1,765,102 participants revealed that while the prevalence of moderate distress decreased from 24.9 % in 2019 to 21.8 % in 2022, the prevalence of high distress increased from 4.7 % to 5.0 % over the same period. Notably, increases in high distress were most prominent among aged 35-49 population. Cross-sectionally, women aged 26-34 showed highest prevalence of high distress (7.6 %). Additionally, mental health service use rose markedly, especially among young adults with high distress, with women consistently reporting higher distress and service utilization than men. These findings suggest a polarization in psychological distress in Japan, with a decline in moderate symptoms concurrent with a rise in severe distress, highlighting emerging gaps in mental health care. The results underscore the need for targeted interventions and the expansion of accessible, diverse mental health services to address unmet needs, particularly among vulnerable subgroups including young women and middle-aged population.

Background: Obesity, considered a worldwide epidemic, generate great interest to the scientific community due to its impact on public health. Particularly in children because of their vulnerability. In view of the bidirectional relationship between obesity and neurodevelopmental aspects, this study aims to evaluate the effect of excess weight on cognitive and behavioural development.

Methods: A total of 130 Spanish children (3 to 12 years) were included. Cognitive function and behaviour were assessed using the validated Wechsler Intelligence Scale for Children-V (WISC-V) and Behaviour Assessment System for Children-3 (BASC-3) tests, respectively. Individuals were classified into groups according to body mass index (BMI) (normal weight and overweight/obesity). Multivariable logistic regression models were performed to address the influence of excess weight on cognitive-behavioural functioning.

Results: The results showed that infants who had overweight/obesity were more likely to have lower scores on the full-scale intelligence quotient (FSIQ: OR adjusted = 3.81, p = 0.006), verbal comprehension (VCI: OR adjusted = 2.57, p = 0.045), fluid reasoning (FRI: OR adjusted = 2.79, p value = 0.030) and working memory index (WMI: OR adjusted = 3.59, p = 0.008). No statistically significant results were found between excess weight and behavioural outcomes after adjustment for confounding factors. Secondly, Spearman's correlation analyses revealed a set of inverse correlations between cognitive ability and various behavioural and emotional problems, especially in cases group.

Conclusions: In conclusion, excess weight may be negatively associated with a worse cognitive performance. Further, poorer cognitive function may lead to greater vulnerability to neurobehavioral disturbances in children with excess weight. These results underscore the need of further investigation.

Objective: This study investigated the association between multiple NDDs and the prevalence and severity of current depression and anxiety among children aged 3-17 years.

Methods: We analyzed parent- or caregiver-reported data from 2016 to 2023 US National Survey of Children's Health. Children aged 3-17 years were included. We considered a broader spectrum of NDDs by including behavioral problems and grouped children based on the number of NDDs (out of ten): no multiple NDDs (none or one NDD), two NDDs, three NDDs, four NDDs, and five or more NDDs. Four mental health outcomes were measured: depression (yes/no), anxiety (yes/no), depression severity (mild/moderate/severe), and anxiety severity (mild/moderate/severe). Multinomial logistic regression models were used.

Results: Among 267,044 children (mean age = 10.2 years; male = 51.8 %), 10.6 % had multiple NDDs. The increasing number of co-occurring NDDs was associated with higher odds of prevalence and severity of depression and anxiety. Children with multiple NDDs were 4.7-5.3 times more likely to have depression and 5.8-12.9 times more likely to have anxiety compared with those without multiple NDDs. These positive associations remained consistent for mild or moderate depression (adjusted odds ratios [ORs]: 5.0-5.6) and for mild or moderate anxiety (adjusted ORs: 5.6-8.9). The associations were more pronounced for severe mental health conditions, with children being 7.8-16.9 times more likely to experience severe depression and 8.1-34.9 times more likely to experience severe anxiety.

Conclusions: The cumulative mental health burden associated with multiple NDDs emphasizes the need for integrated screening and tailored interventions to support this population.

Acid accumulation (AA) describes the continuum of hydrogen ions concentration in the body reflected by increased acid-base buffer activity manifested by low bicarbonate (HCO3) concentration, increased anion gap (AG) or corrected AG (CAG). AA is associated with dietary acid-load, mitochondrial dysfunction, alcohol-abuse, obesity, hypertension, insulin resistance, and kidney disease. Despite these factors being highly prevalent in bipolar disorder (BD) AA has not been studied in this population. In this study we assessed AA in persons with BD and compared them primarily to controls and secondarily to individuals with BD and alcohol withdrawal syndrome (AWS). Available electronic health record data was analyzed from persons with BD (n = 733) enrolled in the Mayo Clinic Bipolar Disorder Biobank, controls (n = 548) and BD inpatients with AWS (BD + AWS, n = 399). AA analyses were adjusted for age, sex, BMI, and eGFR. Compared to controls, persons with BD had lower HCO3, higher AG, and higher CAG - thus greater acid accumulation. In analyses adjusted for age, sex, BMI, and eGFR we still observed higher AG (10.8 vs 10.1 mEq/L, p = 0.006) and CAG (11.7 vs 10.4 mEq/L, p < 0.001) in BD. In a secondary analysis considering BD + AWS and excluding persons with alcohol use disorder in the other groups, persons with BD + AWS had significantly higher AA than both persons with BD and controls (all p < 0.001). We found greater AA in persons with BD, and this was accentuated in BD + AWS. Future studies may focus on the risk factors of AA in BD to personalize prevention strategies.

Despite growing recognition of health as a multidimensional construct, few studies have examined how physical, psychological, and behavioral health dimensions coalesce and evolve across the transition from young to middle adulthood, especially within the context of life-course adversities. Existing research often focuses on isolated health indicators or overlooks the dynamic, fluid nature of health over time. Additionally, the combined effects of childhood and adulthood adversities on health transitions remain underexplored. This study addresses these gaps by employing latent profile analysis (LPA) to identify health classes at distinct developmental stages and latent transition analysis (LTM) to examine the stability and predictors influencing transitions between these states. The analysis includes 2798 individuals from four waves of the National Longitudinal Study of Adolescent to Adult Health. We identified three consistent health profiles-healthy, moderately healthy, and troubled-and tracked how individuals transitioned between these profiles over time. Our findings demonstrate that both childhood and adulthood adversities, including emotional abuse, community violence, and homelessness, significantly influence health deterioration and limit recovery. Notably, our moderation analysis revealed that men were less likely than women to transition out of poor health following childhood adversities, underscoring the need for gender-sensitive interventions. This study contributes to a more dynamic, life-course-informed understanding of health and emphasizes the importance of trauma-informed, gender-responsive interventions. By addressing the interplay of multiple health dimensions and adversities, this research provides critical insights for developing targeted policies and interventions aimed at improving long-term health outcomes and promoting health equity across the lifespan.

This study explored the role of metabolic syndrome (MetS) and health-related behaviors in the progression of depressive symptoms over a one-year naturalistic follow-up in patients with depressive disorder. Using data from 153 participants recruited through the Signature Biobank at a psychiatric emergency setting, we tested whether MetS mediated the relationship between health-related behaviors such as smoking, alcohol and drug use, and sleep, and depressive symptom trajectories. Linear mixed models revealed that while depressive symptoms significantly decreased over time, higher MetS score was associated with a slower improvement in depressive symptoms. However, health-related behaviors did not independently predict depressive symptoms, nor did they exert significant indirect effects through MetS. Smoking, alcohol, and drug use, as well as sleep efficiency, showed no direct or mediated association with depression over time. These findings suggest that MetS may represent a biological vulnerability contributing to unfavorable depression trajectories, independent of common behavioral risk factors. The persistent increase in MetS scores over time supports its potential role as a moderator of treatment response, possibly through mechanisms related to inflammation and neuroendocrine dysregulation. Although limitations such as self-reported measures and the acute nature of the clinical population may affect generalizability, this study highlights the importance of addressing metabolic dysfunction in depression management. Future research should further investigate the biological underpinnings linking MetS and depression to inform more personalized and effective therapeutic strategies.

Background: The relationship between spousal depressive symptoms and cardiovascular risk remains understudied despite established links between individual depression and cardiovascular outcomes.

Methods: Using data from 6651 married Chinese adults (≥45 years) in the China Health and Retirement Longitudinal Study (2011-2018), we examined associations between spousal depressive symptoms and incident cardiovascular disease (CVD) using Cox proportional hazards models. Cox models with penalized splines were performed to explore the dose-response relationship. Marginal structural models examined how changes in spousal depressive symptoms over time related to CVD risk. Four-way decomposition analysis quantified the mediating and modifying role of individual depressive symptoms.

Results: Spouses with depressive symptoms were associated with increased CVD risk (hazard ratio [HR]: 1.26, 95 % confidence interval [CI]: 1.06-1.51 for men; HR: 1.29, 95 % CI: 1.08-1.54 for women). Dose-response analyses revealed similar linear patterns in both genders, with each unit increase in spousal depressive symptom score associated with progressive increases in CVD risk. Persistent spousal depressive symptoms were associated with significantly higher CVD risk in both men (HR: 1.44, 95 % CI: 1.04-1.98) and women (HR: 1.51, 95 % CI: 1.08-2.12), while recently remitted or recent-onset symptoms showed no significant associations. Women's own depressive symptoms mediated 26.3 % of this association, while no evidence of mediation was observed in men.

Conclusions: Spousal depressive symptoms represent an important, underrecognized CVD risk factor, highlighting the need for couple-based approaches to mental health care and cardiovascular management, particularly for couples where one partner has persistent depressive symptoms.

Objective: To evaluate the efficacy of real-time EEG-triggered repetitive transcranial magnetic stimulation (rTMS) combined with group therapy versus rTMS alone over the left dorsolateral prefrontal cortex (DLPFC) in adolescents with depression and self-harm behavior.

Methods: A parallel-group randomized controlled trial (RCT) enrolled 160 inpatients aged 12-18 years with depression and recent self-harm (≤2 weeks prior) from June to December 2024. Participants were 1:1 randomized to rTMS alone (control, n = 80) or rTMS plus group therapy (observation, n = 80).

Primary outcome: 4-week change in Hamilton Depression Rating Scale (HAMD-24) scores. Secondary outcomes included anxiety (HAMA-14), suicide risk (SPS), self-harm severity, and neurophysiological markers measured by resting-state EEG (α/θ power, θ/β ratio) and event-related potentials (P300 latency/amplitude) from a task-evoked paradigm. Randomization used computer-generated block sequences (size = 4) with sealed-envelope concealment; outcome assessors were blinded.

Results: Baseline characteristics were balanced. Intention-to-treat analysis showed greater HAMD-24 reduction in the observation group (-14.5 ± 3.2 vs. -9.8 ± 2.9, P < 0.001). Observation group also had significant improvements in HAMA-14 (-10.2 ± 2.5 vs. -6.7 ± 2.1, P < 0.001), SPS (-12.3 ± 4.1 vs. -7.9 ± 3.5, P < 0.001), self-harm severity (-8.7 ± 2.8 vs. -4.9 ± 2.3, P < 0.001), and neurophysiological indices (shorter P300 latency, lower θ/β ratio, all P < 0.001). No severe adverse events occurred.

Conclusion: Real-time EEG-triggered rTMS combined with group therapy demonstrates superior efficacy in improving clinical symptoms and neurophysiological markers for adolescents with depression and self-harm, offering a potential optimized intervention strategy.

Trial registration: This study was registered with ClinicalTrials.gov (Identifier: NCT07047534).